Recommended responses to lapses in professionalism

Area of Science:

• Medical Education
• Professionalism in Healthcare
• Fitness to Practice

Background:

• Project to identify appropriate responses and sanctions for lapses in professionalism among health profession students and teachers.
• Previous identification of 42 forms of poor professionalism, with 37 applicable to clinical teachers.
• Need for greater consistency in fitness-to-practice procedures in UK medical schools and health professions, as per UK Council for Healthcare Regulatory Excellence (2009).

Purpose of the Study:

• To obtain preliminary guidance from medical educators on appropriate student responses to observed lapses in teacher professionalism.
• To contribute to generating consistency in fitness-to-practice procedures across UK medical schools and health professions.
• To foster a culture of 'local resolution' where junior professionals feel empowered to address poor professionalism.

Main Methods:

• Two reference groups of UK medical educators were formed (n=27 and n=35 from one medical school).
• Participants were asked to recommend appropriate student responses to observed lapses in teacher professionalism.
• Focus on undergraduate proto-professional stage and clinical teachers.

Main Results:

• Clear congruence was found within and between the two reference groups.
• Consensus was reached on recommended responses for 90% of the identified professionalism lapses.
• Broad agreement among 62 UK medical educators on whether students should ignore, challenge, discuss, or report teacher's unprofessional behaviors.

Conclusions:

• A broad consensus exists among UK medical educators regarding student responses to teacher professionalism lapses.
• Findings can guide undergraduate fitness-to-practice procedures and promote 'local resolution' of professionalism issues.
• Dissemination and validation of findings are planned to establish a national consensus.